2017 Volume 39 Issue 3 Pages 241-245
Background. We report a case of mediastinal tuberculous lymphadenitis with atelectasis and bronchial polyp caused by a paradoxical reaction. Case. A 46-year-old woman undergoing mediastinal tuberculous lymphadenopathy treatment was admitted to our hospital because of effort dyspnea and right-middle lobe atelectasis after receiving antituberculosis drugs for 3 months. Bronchoscopy revealed a polypoid lesion at the orifice of the right-middle lobe. Histological examination of the lesion revealed an epithelioid-cell granuloma; she was diagnosed with a paradoxical reaction. Furthermore, bronchoscopy revealed a small, red polypoid lesion in the truncus intermedius. The middle lobe polyp decreased in size after continuously receiving antituberculosis drugs. However, the polyp in the truncus intermedius remained enlarged and was eventually diagnosed as an inflammatory polyp by biopsy. Conclusion. Bronchoscopy is useful for detecting the cause of atelectasis during mediastinal tuberculous lymphadenitis treatment.
